Cognitive Behavioural Therapy Described as a Sticking Plaster

Cognitive Behavioural Therapy has been described as a 'sticking plaster' for the problems that people may bring to counselling (Observer, 19/02/06). With reference to the literature, critically evaluate the arguments for and against this view.

Cognitive Behavioural Therapy (CBT) is a combination of two kinds of therapy; cognitive therapy and behavioural therapy (Bush, 2005). It has been shown to have a positive impact on a wide range of mood and anxiety disorders, such as depression, insomnia and panic attacks as well as more recently psychosis (schizophrenia).

However, whether or not CBT actually solves the issue at hand or simply covers it up, as a "sticking plaster" (Martin & Helmore, 2006) has recently been a topic of discussion. This has arisen from psychotherapists whom believe that CBT and it's effects are unproven whereas psychotherapy has been around for over a century and worked well for this duration of time, and thus must be better, despite the lack of evidence available. To quote Holmes (2002), "Absence of Evidence is not Evidence of absence". This debate is of high political importance as although psychotherapy has been around for longer, this should not be the leading factor in the debate. People's quality of life is what should be considered and if there is a therapy which will highly improve this then it should seriously be taken into consideration.

CBT does have it's advantages over other forms of therapy. It is a short term project, usually ranging from 8 to 16 sessions. Plus the risks of taking on this style of treatment are low, especially when compared alongside drug therapies which have many side effects. When compared to psychotheraputical methods, CBT is much cheaper and a more short term style of treatment, which certainly has it's advantages. However, as with any relatively new therapy, it's long term effects cannot be fully predicted until it has been in use for many years, although there has been mixed evidence about relapse rates among patients whom have received it (Elkin et al., 1989). Another issue with CBT is it's clinical relevance. Although efficacy is high, it's clinical relevance has been questioned, for instance, Leff, Vearnals Brewin, Wolff, Alexander and Asen (2000) discluded CBT from their trials in treating depression due to it's poor compliance from patients whom were considered as "clinically typical" (Holmes, 2002). Additionally it may show a relatively slow speed of response (Health 24 - News, Sleep, 2004) although research is conflicting and some suggests this not to be true.

One of the current major areas of use for CBT is in the treatment of mood disorders, namely uni-polar depression (depression). Many studies have researched into the efficacy and clinical effectiveness of CBT on patients suffering from depression. Butler, Chapman, Forman and Beck (2006) state that due the large number of psychodynamic therapists available to treat individuals the most important comparisons which need to be made are between these psychodynamic therapies and CBT. One of the largest studies regarding this was carried out by Elkin et al. (1989), comparing the effectiveness of CBT, interpersonal psychotherapy (ITP) and drug therapy. However, no differences were found between the treatments of ITP and CBT and the effects they had upon the depressed patients, although both were found to significantly decrease the depressive symptoms of the subjects. In the more severely depressed patients however, CBT did not fare as well as either ITP or drug therapy, suggesting that it does have limitations in the treatment of depression. Sharpio, Barkham, Rees, Hardy, Reynolds and Startup (1994) used the treatments of CBT and psychodynamic-interpersonal therapy (PIT) in assessing which one was best in the treatment of depression whilst also manipulating the length of treatment. It was found that at the end of the treatment CBT and PIT were equally as effective. However, one year after treatment had been completed patients whom had only received 8 sessions of PIT fared worse on almost all measures of their depression when compared those whom had received 8 or 16 treatments of CBT and 16 treatments of PIT. Gloaguen (1998) used meta-analysis to compare the use of CBT and behavioural therapy in treating patients with depression. The study was controlled for using waiting list and placebo controls. CBT was found to be superior when compared to the controls, and also when compared to behavioural therapy, although most of the behavioural therapy trials analysed were uncontrolled. This aside, when compared to control groups CBT does have an advantage over no treatment, which is evidence of the concept that it is better than nothing for individuals suffering from depression as it can improve their quality of life. A recent trial (DeRubeis et al., 2005) found antidepressants (serotonin reuptake inhibitors) to be equally as effective in the treatment of individuals with moderate to severe as CBT. Although both treatments can be seen as equally effective, the use of CBT does not require people to ingest drugs, so if both are equally as effective the CBT would be the clear choice for individuals with depression. The evidence for the area of depression and the usefulness of CBT is mixed, in spite of this, it's merits are clearly obvious.

Another area where CBT is used is in the treatment of individuals with obsessive compulsive disorder (OCD). The use of CBT in this are has been more successful with not only alleviating the symptoms of the disorder, but evidence has also shown it can allow individuals to totally recover from OCD when used in conjunction with drug therapy.

With OCD anti-anxiety drugs were shown not to be effective in most cases of OCD sufferers, (Nolen-Hoeksema, 2007, p.257). Riddle et al. (2001) did, however, find that Antidepressant drugs relieve sufferers from the symptoms of OCD. In their trials over half of the participants in the antidepressant group showed a decrease of their obsessions and compulsions compared to only 5% of the individuals in the placebo group. Although it can be seen that drug treatments do appear to relieve many OCD sufferers from their symptoms, it doesn't work in many sufferers and also comes with many side effects including drowsiness, constipation and loss of sexual interest which results in many sufferers may stop taking the medication, and thus the symptoms of OCD once again arise (Nolen-Hoeksema, 2007). This shows the need for therapies, such as CBT to step into place as a treatment for sufferers of OCD. de Haan, Hoogduin, Buitelaar and Keijsers (1998) tested CBT against the drug treatment clompiramine in children and adolescence. The response to treatment